SkiptoMainContentMinimallyInvasiveandGastrointestinalSurgeryBrowsePeopleEducationResearchViewResearchKindelLabPatientCareViewPatientCareBariatricSurgeryProgramCondonHerniaInstituteGERDandGastrointestinalSurgeryProgramOurTeamResearchandInnovationNewsEventsGivingHome/Departments/Surgery/Divisions/MinimallyInvasiveandGastrointestinalSurgery/PatientCare/GERDandGastrointestinalSurgeryProgram/ParaesophagealHerniaHiatalHerniaParaesophagealHernia(HiatalHernia)Whatisahiatalhernia?Anytimeaninternalbodypartpushesintoanareawhereitdoesn'tbelong,it'scalledahernia.Thehiatusisanopeninginthediaphragm-themuscularwallseparatingthechestcavityfromtheabdomen.Normally,theesophagusgoesthroughthehiatusandattachestothestomach.Inahiatalhernia,thestomachbulgesupintothechestthroughthatopening.Therearetwomaintypesofhiatalhernias:slidingandparaesophageal(nexttotheesophagus).Inaslidinghiatalhernia,thestomachandthesectionoftheesophagusthatjoinsthestomachslideupintothechestthroughthehiatus.Thisisthemorecommontypeofhernia.Theseslidinghiatalherniasareariskfactorfor gastroesophagealrefluxdisease(GERD),andmanypatientswithhiatalherniassufferfromGERDsymptomssuchasheartburn.Slidinghiatalherniasareverycommonandasmanyasmorethan1in4adultshasonebythetimetheyreachtheageof40.Theparaesophagealherniaislesscommonbutismorecauseforconcern.Inmanypatients,paraesophagealherniasmaynotcauseanysymptoms.Theseasymptomaticparaesophagealherniascanbesafelyobservedanddonotrequiresurgery.Whenaparaesophagealherniabeginstocausesymptoms(chestpain,upperabdominalpain,difficultyswallowing),theseareusuallyrepaired.Symptomaticparaesophagealherniasareathigherriskforprogressingtoincarceration(stomachgetsstuckresultinginobstruction)orischemia(bloodsupplytothestomachiscutoff)resultingintheneedforemergencysurgery.Whenshouldaslidinghiatalherniaberepaired?HiatalherniasareknowntocontributetoGERD.Whendiet,lifestylemodifications(loseweight,don’teatlateatnight,sleepupright),andacidreductionmedicationsfailtoadequatelycontrolsymptoms,hiatalherniarepa